• Smoking. A regular smoking habit (including cigars and marijuana) greatly increases the risk of damage to the coronary arteries (more so in women) and dying from heart disease. Chronic exposure to second-hand smoke at work or other places also increases the risk, even in nonsmokers. Smoking is particularly dangerous for women who are taking birth control pills (especially after the age of 35), because the combination has been associated with a significantly increased risk of blood clots. If blood clots either form in, or travel to, the coronary arteries, they then could cause a heart attack.

  • High blood pressure (hypertension). According to the American Heart Association, high blood pressure is more common among men than women until age 55. Between ages 55 and 74, it is slightly more common among women, and over the age of 75, many more women have high blood pressure than men. High blood pressure is a particularly serious problem among black American women, almost 45 percent of whom have elevated blood pressure. Even more serious is poorly controlled high blood pressure, which may be harbinger of an impending heart attack.

  • Cholesterol. Total cholesterol levels should be less than 200, according to the National Cholesterol Education Project, although some organizations have suggested even lower targets. LDL levels should remain below 130. For women who are at “very high risk” of a heart attack, according to the Framingham Risk Calculator, an optimal LDL target of 70 may be pursued.

  • Triglycerides. Women should also carefully monitor their levels of triglycerides, another type of fat in the blood.  The National Cholesterol Education Project recommends that triglyceride levels of less than 150 are considered normal, and up to 199 is borderline high.

  • Low levels of “good” cholesterol (HDL). The American College of Cardiology (ACC) recommends a woman’s HDL level be at least 50 milligrams per deciliter (mg/dL), which is 10 mg/dL higher than the level recommended for a man.

  • A diet high in saturated fat. Whereas unsaturated fats (e.g., fish oil and essential fatty acids) are not harmful and are sometimes helpful, saturated and trans fats (usually found in processed and fast foods) cause the liver to produce higher levels of cholesterol and therefore increase the risk of heart disease. In fact, cholesterol levels are much more strongly linked to saturated and trans fats in a person’s diet than how much cholesterol the person eats (e.g., from eggs).

  • Obesity (a body mass index [BMI] greater than 30 is considered obese, and a BMI of 20 to 25 is considered normal). Obesity is the second leading cause of preventable death, contributing to serious health problems such as heart disease, diabetes, cancer and stroke. Obese individuals are much more likely to die from a heart attack than those who are not.

  • Lack of regular exercise. Heart disease is twice as likely in inactive woman than in those who get regular exercise – at least 30 minutes three times per week. Studies have shown a correlation between physical fitness and lower levels of C-reactive protein. Elevated levels of C-reactive protein are interpreted as a sign of inflammation in the body and a “marker” of the process of heart disease.

  • Excessive alcohol use. Recent studies have reported that women who have one drink per day are less likely to have a heart attack than a non-drinker. However, the opposite effect has been associated with drinking too much alcohol. Women who drink heavily on a regular basis have higher rates of heart disease (and breast cancer) than either light drinkers or nondrinkers.

  • Family history of heart disease. Women, like men, are more likely to develop heart disease if heart disease runs in their family.

  • Race. African American women have a greater risk of heart disease and heart attack at a young age than white women, largely due to higher average blood pressure levels in African Americans.

  • Diabetes. Regardless of blood sugar control, diabetic women are twice as likely to suffer from heart disease as non-diabetic women, according to the American Heart Association. Similarly, the impact of diabetes on stroke risk is greater for women than men.

  • Polycystic ovaries. A recent study found stiffer and less elastic carotid arteries in women with polycystic ovaries and, to a greater extent, women diagnosed with polycystic ovary syndrome. Polycystic ovaries are enlarged ovaries containing numerous small cysts. In this syndrome's severe form, both the cysts and size of the ovaries increase further, accompanied by a syndrome of hormonal side effects (chronically absent menstrual periods, infertility, obesity, high blood pressure, excess facial hair and/or type 2 diabetes). Carotid arteries supply blood to the head and neck. Researchers believe that stiffness in these arteries may mean that other arteries in the body are damaged, thereby possibly increasing the risk of coronary artery disease.

  • High blood levels of inflammatory markers. Research has found a link between heart disease risk and high blood levels of inflammatory markers – substances released by the body in response to inflammation. Two such markers are C-reactive protein (CRP) and interleukin-6 (IL-6). Studies show higher levels of both CRP and IL-6 with increasing age, body mass index, blood pressure and exposure to tobacco smoke. High levels of IL-6 alone are associated with excess alcohol intake, diabetes and lack of exercise. High levels of CRP alone have been found in women taking hormone replacement therapy.